Dr Rahul Sen

Pregnancy nutrition – Iron in Pregnancy

What is iron and why do I need it?

Iron is a mineral that is involved in making red blood cells, carrying oxygen and producing energy.  It is therefore important to ensure you’re eating enough of it!

What is different in pregnancy nutrition?

In pregnancy, your iron requirements rise greatly so you can provide for your baby’s blood supply and build up their stores.   If you eat meat, you should aim to include red meat at least three times per week as well as choosing white meats, eggs, wholegrain bread and fortified cereals, legumes and vegetables regularly.  Vegetarian women will need to rely more heavily on plant sources of iron, which aren’t as well absorbed by the body.

Why does my iron level matter?

Iron deficiency can lead to complications for you and your baby.  Women who are low in iron have a higher risk of small for gestational age babies as well as premature delivery.  Women themselves usually feel quite fatigued and may become short of breath.

How do I know if I’m getting enough iron in my pregnancy diet?

Even if you do eat red meat, it is often difficult to consume the amount of iron that is needed in the last trimester of pregnancy.  However, not all women will become iron deficient (anaemic), even those that follow vegetarian diets.  It will depend in part on how well you absorb iron and on your body’s initial store.

Dr Sen will check your ferritin (body store) level, usually when you are around 26-28 weeks.  Your haemoglobin level (amount of iron in your blood) is also checked, but as your blood supply doubles during your pregnancy, this level drops due to a ‘dilution’ effect and therefore isn’t reliable as a measure of iron deficiency.

Supplements

If your ferritin level is low increasing your intake of red meat will not be enough to increase your stores.  You will need to begin taking a high dose iron supplement formula (usually FerroGrad + C or Maltofer or Ferrotabs) 1-2/day depending on your result.  Iron supplements may cause tummy upset including constipation or diarrhoea, especially in higher doses.  If you suffer any discomfort, try taking it every 2nd day rather than stopping it all together.  Low dose iron or the iron in your multivitamin (if you’re taking) is not sufficient. It is normal that your stool colour can change to very dark/black.  This is not dangerous.  Dr Sen may also discuss the possibility of an iron infusion with you.

Iron supplements should be continued until 6 weeks after delivery, though if you’ve been taking more than 1/day you can decrease to just 1/day from when you have your baby.  Iron supplements are best consumed away from dairy products or calcium supplements.

It is not advised that women take a high dose iron supplement unless they have been shown to have iron deficiency.

If you have any more questions regarding your pregnancy nutrition, visit our website.